Tywanna L Chisley, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R1718 Issued in TX

Practice address

3430 Center St
Deer Park, TX 77536-5056

Phone

(832) 548-5000

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AACHCD
• Direct secure messaging: tywanna.chisley.1@27760.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memorial Hermann Urgent Care PLLC

  • Family Medicine Physician
  • Sugar Land, TX
  • NPI 1730821208
  Medicare reassignment NPD
• Imagine Pediatrics of Florida LLC

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1104542232
  NPD (past)
• Primary Health Services Center

  • Federally Qualified Health Center (FQHC)
  • West Monroe, LA
  • NPI 1104384205
  NPD (past)
• Primary Health Services Center

  • Federally Qualified Health Center (FQHC)
  • Monroe, LA
  • NPI 1316291495
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1699736397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308",
            "telephone_number": "832-548-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 CENTER ST",
            "city": "DEER PARK",
            "state": "TX",
            "postal_code": "775365056",
            "telephone_number": "832-548-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISLEY",
        "first_name": "TYWANNA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R1718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Cervantes, LCSW
• Madelyn Chambers, LCDCI
• Blair Lyanne Chandler, FNP-C
• Charles W Allen Mdpa
• Rita Ann Chessher
• City of Deer Park
• Jeremiah E Clifford, LCDC
• Martha Diana Cohen, DDS
• Community Health 1St ER, LLC
• Concentra Health Services, Inc.

• Pediatrics Physician in Deer Park, TX
• Providers in Deer Park, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.